Provider Demographics
NPI:1881797405
Name:CULLMAN OB GYN PC
Entity type:Organization
Organization Name:CULLMAN OB GYN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:FOSTER
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:256-739-2626
Mailing Address - Street 1:1890 AL HWY 157
Mailing Address - Street 2:STE 220
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058
Mailing Address - Country:US
Mailing Address - Phone:256-739-2626
Mailing Address - Fax:256-739-6588
Practice Address - Street 1:1890 AL HWY 157
Practice Address - Street 2:STE 220
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058
Practice Address - Country:US
Practice Address - Phone:256-739-2626
Practice Address - Fax:256-739-6588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALCC0597OtherMEDICARE RAILROAD
ALD554Medicare ID - Type Unspecified